Searching for Best Predictors of Paralinguistic Comprehension and Production of Emotions in Communication in Adults With Moderate Intellectual Disability.

Paralinguistic comprehension and production of emotions in communication include the skills of recognizing and interpreting emotional states with the help of facial expressions, prosody and intonation. In the relevant scientific literature, the skills of paralinguistic comprehension and production of emotions in communication are related primarily to receptive language abilities, although some authors found also their correlations with intellectual abilities and acoustic features of the voice. Therefore, the aim of this study was to investigate which of the mentioned variables (receptive language ability, acoustic features of voice, intellectual ability, social-demographic), presents the most relevant predictor of paralinguistic comprehension and paralinguistic production of emotions in communication in adults with moderate intellectual disabilities (MID). The sample included 41 adults with MID, 20-49 years of age (M = 34.34, SD = 7.809), 29 of whom had MID of unknown etiology, while 12 had Down syndrome. All participants are native speakers of Serbian. Two subscales from The Assessment Battery for Communication - Paralinguistic comprehension of emotions in communication and Paralinguistic production of emotions in communication, were used to assess the examinees from the aspect of paralinguistic comprehension and production skills. For the graduation of examinees from the aspect of assumed predictor variables, the following instruments were used: Peabody Picture Vocabulary Test was used to assess receptive language abilities, Computerized Speech Lab ("Kay Elemetrics" Corp., model 4300) was used to assess acoustic features of voice, and Raven's Progressive Matrices were used to assess intellectual ability. Hierarchical regression analysis was applied to investigate to which extent the proposed variables present an actual predictor variables for paralinguistic comprehension and production of emotions in communication as dependent variables. The results of this analysis showed that only receptive language skills had statistically significant predictive value for paralinguistic comprehension of emotions (ß = 0.468, t = 2.236, p < 0.05), while the factor related to voice frequency and interruptions, form the domain of acoustic voice characteristics, displays predictive value for paralinguistic production of emotions (ß = 0.280, t = 2.076, p < 0.05). Consequently, this study, in the adult population with MID, evidenced a greater importance of voice and language in relation to intellectual abilities in understanding and producing emotions.

Voice analysis before and after vocal rehabilitation in patients following open surgery on vocal cords.

BACKGROUND/AIM: The major role of larynx in speech, respiration and swallowing makes carcinomas of this region and their treatment very influential for patients' life quality. The aim of this study was to assess the importance of voice therapy in patients after open surgery on vocal cords. METHODS: This study included 21 male patients and the control group of 19 subjects. The vowel (A) was recorded and analyzed for each examinee. All the patients were recorded twice: firstly, when they contacted the clinic and secondly, after a three-month vocal therapy, which was held twiceper week on an outpatient basis. The voice analysis was carried out in the Ear, Nose and Throat (ENT) Clinic, Clinical Hospital Center "Zvezdara" in Belgrade. RESULTS: The values of the acoustic parameters in the patients submitted to open surgery on the vocal cords before vocal rehabilitation and the control group subjects were significantly different in all specified parameters. These results suggest that the voice of the patients was damaged before vocal rehabilitation. The results of the acoustic parameters of the vowel (A) before and after vocal rehabilitation of the patients with open surgery on vocal cords were statistically significantly different. Among the parameters--Jitter (%), Shimmer (%)--the observed difference was highly statistically significant (p < 0.01). The voice turbulence index and the noise/harmonic ratio were also notably improved, and the observed difference was statistically significant (p < 0.05). The analysis of the tremor intensity index showed no significant improvement and the observed difference was not statistically significant (p > 0.05 ). CONCLUSION. There was a significant improvement of the acoustic parameters of the vowel (A) in the study subjects three months following vocal therapy. Only one out of five representative parameters showed no significant improvement.

Acoustic and perceptual characteristics of the voice in patients with vocal polyps after surgery and voice therapy.

OBJECTIVE: The aim of the study was to assess the effect of endolaryngeal phonomicrosurgery (EPM) and voice therapy in patients with vocal fold polyps using perceptual and acoustic analysis before and after both therapies. METHODS: The acoustic tests and perceptual evaluation of voice were carried out on 41 female patients with vocal fold polyp before and after EPM and voice therapy. Both therapy strategies were performed. Used acoustic parameters were Jitter percent (Jitt), pitch perturbation quotient (PPQ), shimmer percent (Shim), amplitude perturbation quotient (APQ), fundamental frequency variation (vF0), noise-to-harmonic ratio (NHR), Voice Turbulence Index (VTI). For perceptual evaluation, GRB scale was used. RESULTS: Results indicated higher values of investigated parameters in patients' group than in the control group (P < 0.01). Good correlation between the perceptual hoarseness factors of GRB scale and objective acoustic voice parameters were observed. All analyzed acoustic parameters improved after the phonomicrosurgery and voice therapy and tend to approach to values of the control group. For Jitt percent, Shim percent, vF0, VTI, and NHR, there were statistically significant differences. Perceptual voice evaluation revealed statistically significantly (P < 0.01) decreased rating of G (grade), R (rough) and B (breathy) after surgery and voice therapy. CONCLUSIONS: Our data indicated that both acoustic and perceptual characteristic of voice in patients with vocal polyps significantly improved after phonomicrosurgical and voice treatment.

Why do treatment failure and recurrences of benign paroxysmal positional vertigo occur?

OBJECTIVE: To investigate the potential risk factors associated to the treatment failure and recurrence of benign paroxysmal positional vertigo (BPPV). STUDY DESIGN: Prospective cohort study. SETTING: Tertiary referral center. PATIENTS: Four hundred patients with benign paroxysmal positional vertigo, 119 men and 281 women, aged 27 to 88 years. INTERVENTION: Patients were treated once a week, with only one, appropriate, depending on the affected canal, repositioning maneuver (modified Epley, Semont, barbecue/inverted Gufoni, Kim). The control Dix-Hallpike test and the roll test were performed on 7 days. MAIN OUTCOME MEASURES: The treatment outcome and recurrence were evaluated with regard to sex, age, duration of symptoms, etiologic factors, migraines, osteoporosis, vascular risk factors, endocrine diseases, localization of otoconia, and simultaneous involvement of multiple canals. RESULTS: The results indicate that treatment was negatively affected by patients' age, osteoporosis, and head trauma, without them causing recurrent symptoms. The highest number of uncured patients was observed in the 73- to 88-year-old age group (14.8%). The application of more than one maneuver was necessary in 27.5% of cases with primary BPPV and 88.9% with secondary BPPV. The highest treatment success was achieved in the group with BPPV of the posterior semicircular canal (F = 3.668, p = 0.026). The recurrence rate was 15.5%. CONCLUSION: Potential risk factors associated to the treatment failure were as follows: the age older than 50, secondary BPPV, head trauma, the occurrence of osteoporosis, and localization of otoconia in the anterior semicircular canal. The analyzed factors did not have impact on the recurrence.

Analysis of voice impairment in aphasia after stroke-underlying neuroanatomical substrates.

Phonation is a fundamental feature of human communication. Control of phonation in the context of speech-language disturbances has traditionally been considered a characteristic of lesions to subcortical structures and pathways. Evidence suggests however, that cortical lesions may also implicate phonation. We carried out acoustic and perceptual analyses of the phonation of /a/ in 60 males with aphasia (20 Wernicke's, 20 Broca's, 20 subcortical aphasia) and 20 males matched in age with no neurological or speech-language disturbances. All groups with aphasia were significantly more impaired on the majority of acoustic and perceptual measures as compared with the control speakers. Within the subjects with aphasia, subjects with subcortical aphasia were more impaired on most measures compared to subjects with Broca's aphasia, and they, in turn, more impaired than those with Wernicke's aphasia. Lesions in regions involved in sound production-perception result in dysfunction of the entire neurocognitive system of articulation-phonological language processing.

[Voice analysis before and after vocal tiredness].

BACKGROUND/AIM: A school teacher's occupation is one of the most vocal demanding professions. Vocal tiredness affects acoustic characteristics of voice, leads to the change in acoustic quality during vocal production. The aim of this study was to examine the influence of vocal tiredness on voice acoustic characteristics of school teachers. METHODS: The study included 36 school teachers (16 male and 20 female) of 27-58 years of age. Vocal tiredness was evaluated by analyzing acoustic parameters of voice, using computerized laboratory "Kay Elemetrics". The voices were recorded before the first class on the beginning of a working week and after the last class at the end of a working week. Signal, noise and tremor parameters were processed. In their analysis the methods of descriptive statistics, as well as the analytical statistics (Student's t-test for paired samples, chi2 test, Mann Whitney U-test and Pearson's correlation coefficient) were applied. RESULTS: The obtained results showed statistically significant differences in average values of parameters as a consequence of the vocal tiredness (p < 0.01), while gender, age and being smoker or not, did not have a significant effect on voice acoustic characteristics in this group of examinees (p > 0.05). CONCLUSION: The results of the study suggest a casual relationship between vocal tiredness and voice quality in vocal professionals.

Acoustic voice analysis of patients with vocal fold polyp.

OBJECTIVES: The aim of the investigation was to obtain acoustic correlates of the vocal quality of patients with vocal polyps, before and after the endolaryngeal phonomicrosurgery (EPM). METHODS: Acoustic voice tests were carried out on 46 female patients with vocal fold polyp, before the EPM intervention and 3 weeks after its completion. Acoustic voice parameters were compared with the control group without voice pathology. The results of the investigation were analyzed acoustically. RESULTS: The results showed that jitter (%), shimmer (%), fundamental frequency variation (vF(0)), voice turbulence index (VTI), pitch perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and NHR values significantly differentiate the patients with vocal fold polyps from a control group without any pathological changes in the larynx. All of the analyzed parameters improved significantly (P<0.05) after the phonomicrosurgical intervention and tended to reach normal values. CONCLUSIONS: The acoustic voice analysis may be used for presurgical and postsurgical voice-status evaluation.

[Multidimensional acoustic analysis of pathological voice].

INTRODUCTION: There are subjective and objective ways to examine the effects of vocal therapy in voice disorders. The most precise and objective check-up is the use of computer voice analysis. OBJECTIVE: The aim of the research was to perform a detailed analysis of acoustic structure of the vowel A before and after voice treatment in patients with vocal fold nodules in order to obtain objective verification of the vocal rehabilitation success. METHODS: We examined 30 female patients, aged 34.6 +/- 6.69 years, with vocal fold nodules. Acoustic parameters of voice were compared with the control group consisting of 21 subjects without voice pathology. In all persons the vowel A was recorded and analyzed before and after a month of vocal therapy. The success of the vocal therapy was tracked using computer analysis of vocal structure. Signal, noise and tremor parameters were processed. RESULTS: Of the analyzed vowel A parameters: STD, PER, JITA, JITT, RAP, vFO, ShdB, SHIM, APQ, VTI, SPI, FO, NHR, FTRI, eleven improved (p < 0.05 and p < 0.01). Three parameters (FO, NHR, FTRI) changed showing improvement, but the obtained differences were not statistically significant (p > 0.05). CONCLUSION: Based on the obtained results it was concluded that vocal therapy gave satisfactory results, but that it should be continually applied until full stabilization of the voice.

[Meningitis as cochlear implant complication].

Over the last several decades, cochlear implantation has been fully proven as the treatment for profound hearing losses. The direct electrical stimulation of the spiral ganglion hair cells through the electrode inserted in the cochlear scala tympani is the essence of the cochlear implant (CI) functioning. Modern technological development has introduced unexpected technical quality possibilities of the device itself, as well as coding strategies, which further enable improved patients' rehabilitation results. Nevertheless, in spite of cochlear implantation becoming a routine surgical procedure, which has been changing lives of thousands of profoundly deaf adults and children, it has possible complications. Though rare, these complications could lead to severe, even fatal consequences. Bacterial meningitis represents one of the most severe postoperative complications. In this article, our five-year experience with cochlear implantation is shown, compared to other, much bigger, experiences. Despite severity and a potentially fatal outcome of meningitis, it has rarely been seen, and the precise connection between surgical procedure and this complication is not yet clear. Do cochlear implants increase the risk of bacterial meningitis? Are deafness-associated factors predisposing the bacterial meningitis occurrence, independently from the implant? These are the questions that the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the CI surgeons have been facing, as well as manufacturers and patients with their families.